Pontine haemorrhage

Prognosis

The prognosis of primary pontine haemorrhage was previously
reported to be very poor, but the use of CT scanning has allowed the detection
of small pontine haemorrhages that would previously not be detected

Patients with a poor prognosis became comatose within 2
hours of onset, their pupils were dilated bilaterally, pin-point or anisocoric
and the transverse diameter of the haematoma was over 20 mm.

These findings are similar to the findings from a series
of 32 brainstem haemorrhages, except with respect to the size of the
haematoma. The patients were divided into 3 groups on the basis of eventual
outcome. Approximately 1/3 died within 1 month, 1/3 were severely disabled (most
were alert, quadiplegic and communicated only with great difficulty) and 1/3 had
only minimal neurological disability. Good prognosis was associated with
alertness or only slight disturbance of consciousness, normal respiration,
positive light reflex, normal heart rate and haematoma <2.5 cm.